H1N1- question about being contagious

[Cairber]

So I was teaching a karate class today and there were 16 kids in the class ages 6-8. One girl was coughing a lot- a very throaty wet cough. But this class isn't too active really; we didn't even do kicks today but she was coughing and coughing. At the end of class, the waiting room was full of parents and she was still coughing. A parent asked her if she was ok and whether she had just a cold. She answered that she had "swine flu."

Immediately I thought she was kinda embellishing or making it up, maybe repeating something her parents had said in passing. But then her father, when he showed up and another parent questioned him, said she had been diagnosed with H1N1 but that had been 5 days previous and she was "fever free today, so we kept her home from school one more day" and then he continued to tell some story about needing to get out and taking her to a karate class because the doctor said it was ok.

My question is-- with such a wet, disgusting cough and only having been fever free for that particular day, isn't she still contagious?

If so, is there anything I can do now that I have been exposed? I worked one on one with her for a while and she did cough at me a few times.

[Vyraeth]

My question is-- with such a wet, disgusting cough and only having been fever free for that particular day, isn't she still contagious?

It is difficult to say precisely as I do not know if the girl has a history of coughing or allergies and what not, but the National Health Service in the United Kingdom suggests that it is safe for people to have contracted the virus to be in contact with other people when all of their symptoms have subsided. It doesn't seem like the presence of a fever matters, as coughing is certainly a symptom, but the cough may have been caused from other factors. However, that does seem relatively unlikely, given her recent exposure to the virus.

Here is the link to the National Health Service's website where they describe all aspects of the virus:
http://www.nhs.uk/conditions/pandemic-f ... incubation

If so, is there anything I can do now that I have been exposed?

I'm not aware of anything you can do at present. So far as I know, there's no magical way to prevent the virus from progressing. If you are infected, it has already started replicating. The advantage you have, however, is that knowing you're potentially at risk for exposure. If you develop any cold-like symptoms, I would recommend talking to your doctor without delay - as it is generally recommended that you start anti-viral medication as soon as possible. The NHS article I read says that symptoms can appear as soon as two days, or as long as seven days.

Here are a few links from the CDC about antiviral medication for H1N1, and what to do if you contract the flu:

http://www.cdc.gov/H1N1flu/antiviral.htm
http://www.cdc.gov/H1N1flu/guidance_homecare.htm

Also symptoms for swine flu from the NHS: http://www.nhs.uk/Conditions/Pandemic-f ... ptoms.aspx

I hope everything works out for you, and that the links help.

[Broomstick]

Ooo, people like that burn me up!

She should not have been at karate class! She is still symptomatic, still needs to be at home resting/recuperating, and should not be exposed to any other illness that may making the rounds!

[PeZook]

The doctor said it was ok for her to undertake some physical activity like karate when she was coughing her lungs out?

What?

[Tolya]

The doctor said it was ok for her to undertake some physical activity like karate when she was coughing her lungs out?

What?

Being a pole you should know that good doctors are a rarity. I-dont-care uneducated SOB's are probably as common in US as in Poland.

To tell a very sad anecdote: dad of my wife's coworker was diagnosed with stomach cancer. Quite late I might add (T3 stage) because he was living outside a big city and didn't go to see a doctor very often and the outlook was quite bleak - at his local hospital he was given maybe 6 months of life. Anyways, he finally got to an oncologist (no small feat if you live in Poland) in the best public oncologist hospital in Warsaw (Warsaw Center of Oncology) and was given a radiation therapy.

The problem is that nobody - doctor or a nurse - told him that a rad therapy completely obliterates your immune system. What's worse, after he was radiated for the first time, he was... discharged from the hospital. The poor guy went home without any knowledge of the danger that he is in. Luckily since a member of my wife's family has had cancer many years ago, my wife educated her coworker about what needs to be done. But the guy should have never left the hospital at the first place.

It ended quite happily though - he managed to steer clear of any infections and was later admitted to the hospital. After the therapy the tumor subsided and he was given a couple more years of life.

But when you hear stories like that... I get goose bumps.

[Justforfun000]

Ooo, people like that burn me up!

She should not have been at karate class! She is still symptomatic, still needs to be at home resting/recuperating, and should not be exposed to any other illness that may making the rounds!

Jesus, no kidding eh?

You know, in one sense this world is being fantastically lucky that our first pandemic in over 40 years is still in GENERAL relatively mild because it's giving everyone a dress rehearsal of what they have to do to be ultra smart if we ever get a really serious one. If another 1918 one starts spreading around, we can't have this kind of irresponsibility happening or we'll be dropping like flies.

Sadly the deaths that ARE happening, especially involving children, are highlighting the seriousness of this scenario and starting to crack through the resistance people are throwing up against vaccines and common sense measures like taking time off of work instead of spreading it around. There's a great deal of fault to be laid at the feet of employers in this regard however...it's been a very bad trend in America particularly to work people to the bone and not allow time for them to be sick. Indeed, many times they're punished for daring to take time off.

France or Germany are excellent counter-examples to this. Far better at looking after people and letting them recuperate when they need to, and this includes decent vacation periods. Life isn't meant to be 80% work, yet that corporate overdrive meme keeps running people into the ground.

[Broomstick]

Only 80%? There are those in corporate America who'd make life for employees 100% work.

They don't get it. They come to work with raging symptoms and declare "I never get ill". If YOU say you're ill they ask what's wrong with you, why aren't you healthy like everyone else. And right now, taking a day off work due to your illness or your child's illness truly can cost you your job - and need I remind those outside the US that health insurance and access to health care in this country is strongly tied to having a job?

Even if people start dropping like flies as we have a repeat of 1918 with the young and healthy disproportionately affected they STILL won't get it. The workaholics will still drag themselves to work and bitch about the weak tits who are slacking.... until, of course, the workaholics fall over. Which did happen sometimes in 1918.

[FireNexus]

If so, is there anything I can do now that I have been exposed? I worked one on one with her for a while and she did cough at me a few times.

You might see if your doctor will give you prophylactic antivirals. They might not outright prevent you from getting sick, but this soon after exposure they could make your flu much less shitty.

[whackadoodle]

So I was teaching a karate class today and there were 16 kids in the class ages 6-8. One girl was coughing a lot- a very throaty wet cough. But this class isn't too active really; we didn't even do kicks today but she was coughing and coughing. At the end of class, the waiting room was full of parents and she was still coughing. A parent asked her if she was ok and whether she had just a cold. She answered that she had "swine flu."

Weird. I caught swine flu from my wife, who caught it from one of her students at her taekwondo school.

My question is-- with such a wet, disgusting cough and only having been fever free for that particular day, isn't she still contagious?

The official stance on that is she must be fever-free for a full 24 hours before she ceases to be contagious. However, a recent study at the Air Force Academy seems to suggest that communicability may continue beyond that time.

You might see if your doctor will give you prophylactic antivirals. They might not outright prevent you from getting sick, but this soon after exposure they could make your flu much less shitty.

What he said. Tamiflu or Relenza, taken within 48 hours of contracting this flu, can shorten its duration and severity.

[Knife]

If so, is there anything I can do now that I have been exposed? I worked one on one with her for a while and she did cough at me a few times.

c

Keep away from your kids as much as possible for a week to see if you become symptomatic.

[Justforfun000]

What he said. Tamiflu or Relenza, taken within 48 hours of contracting this flu, can shorten its duration and severity.

It's most effective within that period, but it can still shorten it's duration and severity at any time. I started it on my 5th day of infection and started to improve immediately.

[whackadoodle]

It's most effective within that period, but it can still shorten it's duration and severity at any time. I started it on my 5th day of infection and started to improve immediately.

Hmm. I saw my doctor after three days ( I really hate going to the doctor, okay? ) and she said it would be kinda pointless. Mine cleared up after five days, on its own.

[Justforfun000]

Hmm. I saw my doctor after three days ( I really hate going to the doctor, okay? ) and she said it would be kinda pointless. Mine cleared up after five days, on its own.

Maybe you didn't have severe enough symptoms to warrant it? I'm sure mine didn't give it to me just as a placebo. It's actually controlled a bit here. It's usually given in institutionalized settings. Pharmacist had to clear it with the government before he would release it to me. I'm sure they would have said no if they thought it'd be worthless. It makes sense it would have to be effective at any stage..it works by inhibiting the replication of the virus. Until it's completely removed, anything helping that process is going to speed recovery.

[PeZook]

IIRC the reason they mostly don't administer it after symptoms have developed is because it threatens to breed a resistant strain, since the standard dosage won't block replication completely. So unless the symptoms are severe and violent, it would be kinda pointless and also dangerous long-term.

On another note, it's pretty awesome how medicine can do things today that were thought impossible just a few decades ago, like antiviral drugs.

[PainRack]

So I was teaching a karate class today and there were 16 kids in the class ages 6-8. One girl was coughing a lot- a very throaty wet cough. But this class isn't too active really; we didn't even do kicks today but she was coughing and coughing. At the end of class, the waiting room was full of parents and she was still coughing. A parent asked her if she was ok and whether she had just a cold. She answered that she had "swine flu."

Immediately I thought she was kinda embellishing or making it up, maybe repeating something her parents had said in passing. But then her father, when he showed up and another parent questioned him, said she had been diagnosed with H1N1 but that had been 5 days previous and she was "fever free today, so we kept her home from school one more day" and then he continued to tell some story about needing to get out and taking her to a karate class because the doctor said it was ok.

My question is-- with such a wet, disgusting cough and only having been fever free for that particular day, isn't she still contagious?

If so, is there anything I can do now that I have been exposed? I worked one on one with her for a while and she did cough at me a few times.

Don't know about swine flu, but the interesting thing about influenza in the past is.... its not contagious after a few days.
http://www.hsc.mb.ca/influenza.htm
Its entirely possible that you're still symptomatic but no longer infectious....
What she's doing outdoors instead of being at rest though........................ There are two schools of thought about this. You do need some form of activity because enforced bed rest actually leads to MORE complications. But.....

[Justforfun000]

IIRC the reason they mostly don't administer it after symptoms have developed is because it threatens to breed a resistant strain, since the standard dosage won't block replication completely. So unless the symptoms are severe and violent, it would be kinda pointless and also dangerous long-term.

Ah I see. Well I certainly qualified for the severe and violent. The worst thing about it is the quarantine. Today will be 3 days of work I lost. Even though I feel much better and my fever symptoms started going completely yesterday, technically one more day should put me completely past the danger area. Better safe then sorry to everyone. I think it's already been said, but it's either 7 days from the start of the first fever or 24 hours since the last temperature. Approximately of course.

[PainRack]

Being a pole you should know that good doctors are a rarity. I-dont-care uneducated SOB's are probably as common in US as in Poland.

To tell a very sad anecdote: dad of my wife's coworker was diagnosed with stomach cancer. Quite late I might add (T3 stage) because he was living outside a big city and didn't go to see a doctor very often and the outlook was quite bleak - at his local hospital he was given maybe 6 months of life. Anyways, he finally got to an oncologist (no small feat if you live in Poland) in the best public oncologist hospital in Warsaw (Warsaw Center of Oncology) and was given a radiation therapy.

The problem is that nobody - doctor or a nurse - told him that a rad therapy completely obliterates your immune system. What's worse, after he was radiated for the first time, he was... discharged from the hospital. The poor guy went home without any knowledge of the danger that he is in. Luckily since a member of my wife's family has had cancer many years ago, my wife educated her coworker about what needs to be done. But the guy should have never left the hospital at the first place.

It ended quite happily though - he managed to steer clear of any infections and was later admitted to the hospital. After the therapy the tumor subsided and he was given a couple more years of life.

But when you hear stories like that... I get goose bumps.

No it doesn't. Or rather.... it doesn't work that way.
1. First of all, being diagnosed as a stage III stomach cancer isn't that unusual. Outside of Japan, nobody in the world does the screening necessary to catch stomach cancer at stage II or lesser. Its asymptomatic for one until the late stages. The only reason why people are diagnosed at stage I and II is when the doctor pops in an endoscope regarding other health matters.

2. You didn't give any specifics about the radiation therapy. Its not unusual for patients who are well to go home after the planning and the first shot, to be done as an outpatient. Given that you never did say whether he went back for radiation as an outpatient, I'm going to assume he completed the entire course inpatient and was then discharged... All this is normal.

3. RT for palliative stomach cancer DOES NOT LEAVE YOUR BODY DEFENCELESS. You're talking about a TBI, something done for Bone Marrow Transplant. Indeed, if the radiation doesn't hit any of your bone marrow spots such as the hip bones, your immunity is simply NOT GOING TO BE AFFECTED. No haematopeic cells are affected during radiation therapy for stomach cancer.

http://www.cancer.gov/cancertopics/radi ... -you/page6

To put it simply, the only things he needed to know was fatigue and skin changes. Hell, IIRC, given that its over the stomach, you don't even need to worry about photosensitivity.

[PainRack]

And to add to the general health advice, drink more fluids, have a healthy diet, get enough sleep and try not to stress yourself.
And there isn't any actual harm in popping in some more Vitamin C via fruits.......

Edit with regards to Stomach Cancer: I assumed he wasn't taking any oral chemotherapy with regards to RT.

[PeZook]

Being a pole you should know that good doctors are a rarity. I-dont-care uneducated SOB's are probably as common in US as in Poland.

Actually, I never had much of a problem with any of my doctors. My mom saw two, I think, who would qualify as "doesn't give a fuck", though.

I sometimes wonder just how prevalent the problem really is, since anecdote isn't data and all. After reading up on US health care, though, I suddendly began to appreciate Polish health care a lot more than I used to despite all its flaws and problems, most of which are annoying, rather than crippling.

To tie to your example, at least your wife's coworker's family isn't up to their eyeballs in medical debt from the procedures. Think about it: he lived outside a big city, yet managed to get treatment at the Warsaw Oncological Center. For free.

I know it ain't perfect, but as Painrack explained, the case looks rather bog-standard as far as they go.

[Tolya]

-snip-

Oh, I didn't know all that, thanks Painrack. I would be happy to provide more detailed data on that case, but unfortunately I have never met him and all information that I have is only anecdotal.